Birth Weight and Order as Risk Factors for Childhood Central Nervous System Tumors

Objective To determine whether birth characteristics related to maternal-fetal health in utero are associated with the development of childhood central nervous system tumors. Study design We identified, from the California Cancer Registry, 3733 children under age 15 diagnosed with childhood central nervous system tumors between 1988 and 2006 and linked these cases to their California birth certificates. Four controls per case, matched on birth date and sex, were randomly selected from the same birth files. We evaluated associations of multiple childhood CNS tumor subtypes with birth weight and birth order. Results Low birth weight was associated with a reduced risk of low-grade gliomas (OR = 0.67; 95% CI, 0.46 to 0.97) and high birth weight was associated with increased risk of high-grade gliomas (OR = 1.57; 95% CI, 1.16 to 2.12). High birth order (fourth or higher) was associated with decreased risk of low-grade gliomas (OR = 0.75; 95% CI, 0.56 to 0.99) and increased risk of high-grade gliomas (OR = 1.32; 95% CI, 1.01 to 1.72 for second order). Conclusions Factors that drive growth in utero may increase the risk of low-grade gliomas. There may be a similar relationship in high-grade gliomas, although other factors, such as early infection, may modify this association. Additional investigation is warranted to validate and further define these findings. (J Pediatr 2010; 157: 450-5).